• Groundbreaking HHS Secretarial Summit on Electronic Health Record
• Gabe Rios Named Associate Director for Public Services
• InfoPOEMs/InfoRetriever Added to Library's Collection
• Assuring the Library Collection Is Used
• Project Examines How Library Decisions on Journal Cuts Are Changing
• Library Receives Grants For Special Projects With AIS Partners
• Kronick Authors Book on History of Scientific Journals
• News in Open Access Publishing
• Evidence-Based Practice Summer Institute Held
• E-Journal News
• Library Class Schedule

Groundbreaking HHS Secretarial Summit on Electronic Health Record

Even before the IAIMS Report was jointly published in 1983 by a librarian and a physician, librarians have been inspired by a vision of the future that would link patient records with relevant published reports, patient information, and tools for assisting in decision making. Now it appears this vision may be closer to becoming a reality, according to library director, Dr. Mary Moore, who attended the National Health Information Infrastructure conference, a ground-breaking meeting about electronic health records held in Washington, D.C., July 20-23, 2004.

Last April President Bush called for a widespread electronic health record (EHR) to be operational within ten years and created the position of National Health Information Technology Coordinator. Health and Human Services Secretary Tommy G. Thompson named Dr. David Brailer to the position in May. Brailer issued his strategic plan for implementation, The Decade of Health Information Technology: Delivering Consumer-centric and Information-rich Health Care, on Wednesday, July 21, 2004 in Washington, D.C. at the Secretarial Summit on Health Information Technology.

The meeting began with a presentation by Tommy Thompson, who said medical practice lagged behind grocery stores and veterinarians in making use of technology to reduce errors, conserve resources, and improve service. Thompson commended the National Library of Medicine for taking leadership in negotiating a multimillion dollar contract for SNOMED clinical terms, and making them freely available on the web, assisting those seeking to develop electronic health records. (http://www.cap.org/apps/docs/media_resources/newsrel_snomednlmannouncement.htm)

Brailer's report on his strategic plan followed. A summary of the report is available at http://www.hhs.gov/news/press/2004pres/20040721.html. The Framework document is at http://www.hhs.gov/onchit/framework/hitframework.pdf.

Reactor panels of heads of Federal agencies and departments (including NIH, CDC, AHRQ, CMS, FDA, HRSA, DOD, VA and OPM), politicians (Senate Majority Leader Bill Frist, Nancy Johnson, and Patrick Kennedy), the private sector (chairs of IBM Healthcare, GE Healthcare, Cerner, McKesson, Global Health Solutions) and other stakeholders like the AMA, Blue Cross Blue Shield, ACP, AARP, Markle Foundation, HealthCare Partners, HIMSS, and AMIA all endorsed the plan. The day ended with a presentation by Newt Gingrich. Working groups met most of Thursday to refine recommendations that assure stakeholders were represented and functional aspects of the plan addressed, in preparation for testimony before HHS's National Committee on Vital and Health Statistics (NCVHS).

There are many aspects of the plan and operational details that will be challenging. For a full report on this meeting, see the Library's Web page on knowledge management at http://www.library.uthscsa.edu/internet/km/.

Mary Moore, Ph.D.
Director of Libraries

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Gabe Rios Named Associate Director for Public Services

We are pleased to announce that Gabe Rios has been appointed Associate Library Director for Public Services at the UTHSCSA Library. Gabe comes to San Antonio from Charlottesville, Virginia, where he most recently served as Assistant Director for Information Services and Technology at the Health Sciences Library of the University of Virginia. Prior to this position he was director for information services at the Area Health Education Center in North Carolina and circuit librarian at the Medical College of Virginia. Gabe earned his Bachelors degree in Physical Anthropology from the University of Texas San Antonio and his Masters in Library and Information Science from the University of Texas at Austin.

Gabe has presented or taught at over fifteen professional conferences, workshops and courses in the last four years, on the subject of PDA applications and mobile/wireless technologies. He also has a strong background in outreach services to underserved populations and has served as investigator or co-investigator on a number of outreach grants.

Gabe is no stranger to the UTHSCSA, having worked in various departments at the Library while attending college and graduate school. Through the years, he has kept in close contact with Mary Jo Dwyer, UTHSCSA Outreach Librarian, who considers herself to be one of his mentors. Mary Jo established a successful circuit librarian and outreach program in the South Texas Border region.

Mary Moore, UTHSCSA Director of Libraries said, "We had extremely well qualified candidates for this position, but Gabe had special accomplishments and talents that make him the perfect choice, including experience with public services in innovative organizations, and he is recognized for outstanding customer service. He combines two things that are hard to find - technology expertise and zeal for improving the quality of library services. In addition he has successful experience engaging the community in using information resources.

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InfoPOEMs/InfoRetriever Added to Library's Collection

The UTHSCSA has recently acquired access to InfoRetriever, a database system of filtered, synopsized, evidence-based information. Information is presented in a format that allows clinicians to determine the reliability of the evidence as it applies to their clinical questions. InfoRetriever is often referred to as InfoPOEMs, but InfoPOEMs is actually one of the component databases, as well as the name of the company that produces the system.

The heart of the system is InfoPOEMs, designed to keep practitioners current and answer their clinical questions at the point of care. POEM stands for Patient-Oriented Evidence the Matters.T POEMs are based on research findings that are identified and summarized by experts.

InfoRetriever searches seven different databases: InfoPOEMs, Griffith's Five-Minute Clinical Consult, Clinical Rules and Calculators, Diagnostic Test Calculators, History and Physical Test Calculators, Cochrane Database of Systematic Reviews, and Practice Guidelines. The databases can be searched independently or in any combination.

InfoRetriever can be accessed over the Web, downloaded to a Windows-based PC, or installed on a Palm OS or Pocket PC handheld. The PDA versions require approximately 35mb of space on an external memory card-InfoRetriever cannot be installed on a PDA that does not have an external memory card or one whose external memory card is too small. Downloads are available from http://www.infopoems.com/support/downloads.html. Warning: these are large files that can take approximately 25 minutes to download or install.

Users-regardless of whether they have downloaded the InfoRetriever software-can also sign up for DailyPOEMs, an email clinical awareness system offered by InfoPOEMs. With this service, subscribers will receive an InfoPOEM via email every day or on a monthly basis. To sign up for DailyPOEMs, just fill out the form at http://www.library.uthscsa.edu/databases/dailypoems.cfm. It usually takes about two business days to start receiving POEMs. Access to the DailyPOEMs service is part of the Library's subscription; there is no extra fee to receive these updates.

This resource is being funded for one year by the Medical Student Computer Use Fee. InfoRetriever can be found in the Databases list on the Library's website, or can be accessed directly at http://www.infopoems.com/irsearch/irsearch.cfm. Off-campus access is available to UTHSCSA students, faculty, and staff who have registered with the Library and set a PIN. If you have questions or comments about InfoRetriever, please contact the Library Information Desk at 567-2450 or AskaLibrarian@uthscsa.edu.

Lynda Howell, M.L.I.S.
Information Technology Librarian

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Assuring the Library Collection Is Used

As we started this article, we were unsure what to report. We do not know our state budget for next year, and although we are optimistic that we will receive supplemental PUF/LERR funds for the collection, the truth is we will not know until the UT System Regents meet in mid-August. Because we do not know, we are preparing a plan for a worst case scenario. In this scenario, the Library would be faced with a 5% cut in its state allocated budget. We would need to cut the collection by $38,000. In addition, publishers' costs increase by an average of 10% annually, so the total cut to the collections would have to be $114,000.

Even without a budget cut, we know that the goal of library collection development is to assure the collection is highly relevant to your needs, and is used by you. The Library staff has prepared a list of possible titles for cancellation that has been posted to the Web at http://www.library.uthscsa.edu. The list includes print titles that cost more than $25 per use and electronic titles that are used less than 100 times. The list will include titles that are in consortium journal packages to which the Library subscribes through the University of Texas System Digital Library. Preparing to make these cuts will help us to spend our budget wisely, as we remove items that are less used, so we are able to subscribe to new materials that are needed for teaching programs and research.

Mary Moore, Ph.D.
Library Director

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Project Examines How Library Decisions on Journal Cuts Are Changing

The Library reviews its journal collection each year prior to renewing journals in the fall. This year, John Weed, Library Assistant II, conducted a journal review as part of his "Capstone Experience" for the Masters degree of Science and Information Studies at the University of Texas at Austin. Weed's project helped determine which journals are less used. In order to identify titles for possible cancellation, Weed reviewed statistics for internal use (current print journals) and online use (electronic journals) from March 2003 through February 2004. Cost per use was determined whenever possible.

One important finding of Weed's Project is the impact that consortium deals for bundled journal packages have on the Library's ability to cancel. The Library receives a large number of its electronic journal titles through bundled consortium subscriptions. The consortium deals for electronic journals are a double-edged sword - they provide the UTHSCSA access to more titles (not all of which are relevant) yet the consortium licenses limit the Library's ability to cancel titles when budget cuts are necessary. Taking into account specific consortium restrictions, Weed prepared a list of titles proposed for cancellation and conversion to online only format. The lists of titles are currently available on the Library's website (http://www.library.uthscsa.edu). By changing some titles to online only format, the Library saves barely 10% on the subscription cost of these journals.

The resultant savings from these proposed changes to the journal collection is only $28,000, so there is a possibility that once the FY 2005 budget is known, more cuts will have to be made. If that is the case, the Library will need to drop out of a number of consortium deals, thus affecting electronic journals available to the UTHSCSA. Watch the Library's web site for further information.

The final lesson learned from the project is this: In the past libraries cut individual titles when budgets were constrained. Soon we will no longer be able to cut individual titles; we must instead cut entire packages. Gathering feedback on which packages to cut will be very complicated and we will need your help more than ever.

Please send any comments about the proposed cancellations and conversion of print titles to online titles to Rajia Tobia, Associate Library Director for Collection Development, at tobia@uthscsa.edu or Mary Moore, Library Director, at moorem3@uthscsa.edu.

Rajia Tobia, A.M.L.S.
Associate Library Director for Collection Development

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Library Receives Grants For Special Projects With AIS Partners

The Library has received two SBC grants through the UTHSCSA Virtual initiative.

One project will explore alternatives for developing an electronic repository to collect learning objects to be used by UTHSCSA faculty, students, staff and others in the general public to present medical information from a different educational perspective. For our purposes, a learning object is a slide, illustration, animated simulation, audio/video clip, or document. These objects will be digitized, cataloged and assigned medical subject headings, so that they can be retrieved individually and used in a customized manner suited to course material and individual instructional style. The Library will team with Educational Media Resources to identify software and hardware, and gather teaching materials that could be shared. If you have developed original teaching materials and would like to share them with other instructors, students and/or the general public, please contact Sallieann Swanner, M.L.S., Associate Library Director for Systems, at 567-2400 or swanner@uthscsa.edu.

In the second project, the Library and the Alamo Women and Family Health Information Network will develop a regionally relevant consumer health web gateway, linking to a database of local providers of health services in 38 counties in South Texas. In the second phase of this project, Academic Informatics Services Distributed Learning Division will set up learning stations in selected clinics for patient use.

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Kronick Authors Book on History of Scientific Journals

Scientific journal publishing has been much in the news of late, with discussions of open access, the future of scholarly publishing, and the ever growing volume and cost of the scientific literature. It is timely then, for a book to appear that focuses on the history of the scientific journal to lend historical perspective to the debate over journal publishing. Former UTHSCSA Library Director David A. Kronick, Ph.D., a respected authority on the history and development of scientific journals, is the author of "Devant le Deluge" and other Essays on Early Modern Scientific Communication, a collection of essays describing various aspects of scientific publications from the early 17th and 18th century journals to the present.

"Indexing of Early Scientific Periodicals," "Literature of the Life Sciences: The Historical Background," and "The Commerce of Letters: Networks and Invisible Colleges in Early Modern Science" are among the themes discussed. Persons interested in how scientific information has been accessed and disseminated will find "Devant le Deluge" an intriguing work. Dr. Kronick has donated a copy of his book to the UTHSCSA Library and it can be found in the Briscoe Library's 5th floor stacks under the call number WZ 345 K93d 2004.

Pennie Borchers, M.L.S.
Special Collections Librarian

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News in Open Access Publishing

• Dr. Bettie Sue Masters, UTHSCSA Professor of Biochemistry, published an opinion piece on July 8, 2004, "A Professional Society's Take on Access to the Scientific Literature," on Nature's web site as part of the "Web Focus: Access to the Literature: The Debate Continues" (http://www.nature.com/nature/focus/accessdebate/27.html.) The article heralds the centennial of the Journal of Biological Chemistry in 2005. The journal, known for the high quality of its peer-reviewed publications of fundamental advances in biochemistry and molecular biology, was the first biomedical journal to be available electronically, with online coverage now dating back to 1905. Since 2001, manuscripts have been made available online free of charge on the day they are accepted for publication through the Papers in Press (PIPs) program. Masters' article discusses the JBC's open access, cost structure, and peer review system, stating that editorial independence and the quality and quantity of submissions have not been affected by the open access policies of the journal.
  
  
• A bill was recently introduced that would make all NIH-funded research reports free and available on the Web through the National Library of Medicine's PubMed. On August 4th, Dr. Elias Zerhouni, NIH director, convened a meeting at NIH to discuss open access and the language in the House Appropriations Report. There is an account in The Scientist at http://www.biomedcentral.com/news/20040729/04/.
  
  
• In a much anticipated report following several months of testimony by publishers, scientific societies, funding agencies, and open access proponents, the U.K. House of Commons Science and Technology Committee released a lengthy report called "Scientific Publications: Free for All?" The complete text can be found at: http://www.publications.parliament.uk/pa/cm200304/cmselect/cmsctech/399/39902.htm. The report addresses the issues surrounding escalating costs of scientific journals and methods for making research results more accessible, and states: "Digitisation should facilitate not restrict access."

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Evidence-Based Practice Summer Institute Held

The UTHSCSA School of Nursing recently hosted the third annual Summer Institute on Evidence-Based Practice in San Antonio. Invited speakers included Dr. Steven Wartman, who spoke of the need for evidence-based health education, and Dr. Kenneth Shine, who spoke on the Institute of Medicine's health quality reports and called for evidence-based decision making as a means to improving quality of care. The Keynote speaker was Dr. Carolyn Clancy, director of the Agency for Healthcare Research and Quality, who spoke on the role of evidence-based practice in the 21st century. An invited roundtable discussed educational competencies in evidence-based practice for nursing. Molly Harris, medical research librarian at the Veterans Evidence-Based Research Dissemination Implementation Center (VERDICT), received one of the top ten awards for her presentation entitled, "Searching for evidence in the clinical setting." Next year's conference will be held on July 7-9 in San Antonio and should be of great interest to both nurses and librarians.

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E-Journal News

The following electronic journals have recently been added to the UTHSCSA Library's collection. Most of these new e-journals are provided through the Library's membership in the TexShare statewide library consortium, or through subscriptions purchased through the University of Texas System Digital Library. Links to e-journals can be found in the BLIS catalog record for the journal or from the E-journals web page at http://uthscsa.1cate.com. E-journals that are restricted to use in the UTHSCSA domain may be accessed off-campus by UTHSCSA students, faculty, and staff who have registered with the Libraries and set a PIN. An 'embargo' on a journal means that current issues are not available for the embargo period. For more information about journals, contact the Information Desk at 567-2450 or AskaLibrarian@uthscsa.edu.

*Briscoe Library has a current print subscription

Jude Lynch
Library Assistant III, Cataloging

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Suggestions, questions, and comments should be directed to AskaLibrarian@uthscsa.edu